Objective To explore the clinical effect of operative treatment for grade Ⅳ pronation-external rotation ankle injury.Methods 60 patients with pronation extorsion type Ⅳ degree of ankle injury were selected as the research subjects.According to the digital table,they were divided into two groups,30 cases in each group.The group A adopted ordinary steel plate,the group B adopted locking plate fixation.The clinical curative effect,postoperative recovery index,AOFAS score and complications were observed.Results The total effective rate of group A was 93.3％,which of group B was 90.0％,the difference was not statistically significant (x2 =0.218,P ＞ 0.05).The swelling subsided time [(24.2 ± 5.0) d vs.(22.9 ± 4.1) d],fracture healing time [(42.4 ± 9.5) d vs.(41.3 ± 9.4) d],postoperative recovery time of walking [(46.6 ± 9.2) d vs.(45.7 ± 9.0) d],AOFAS score [(87.3 ± 2.6) vs.(88.4 ±2.2)] between the two groups had no statistically significant differences(t =1.101,0.451,0.383,1.769,all P ＞0.05).The group A had 1 case in infection,the incidence rate of complications was 3.3％.The group B had no complication.The difference was not statistically significant in the incidence of complications between the two groups (x2 =1.017,P ＞ 0.05).Conclusion In the operative treatment for patients with grade Ⅳ pronation-external rotation ankle injury,whether choose ordinary steel plate fixation,or choose the locking plate fixation,the clinical effects of the two methods are both good,and the postoperative healing is fast.

PURPOSE To investigate the effects of all trans retinoic acid(ATRA) on the growth of gastric cancer cells and explore the mechanism relevant to enzyme.METHODS With MTT method the growth inhibition of gastric cancer cells was measured;the activity of lactate dehydrogenase(LDH),alkaline phosphatase(ALP) and ? glucuronidase(? G) was measured with metaplate;The activity of succinate dehydrogenase(SDH) was assayed with cytochemical method.RESULTS The growth of MGc80 3, but not MKN 45, was inhibited,which is dependent on the concentration of ATRA.The activity of LDH,ALP and ? G of Mgc80 3 was suppressed and the activity of SDH of Mgc80 3 was enhanced.But all the four enzymes′ activity of MKN 45 were not obviously changed except that introcelluar ? G activity was inhibited.CONCLUSIONS The sensitivity of gastric cancer cells to ATRA is different,which is closely related with the change of enzyme activity.

Objective To explore the clinical characteristics,pathological features,therapy and prognosis of a case of splenic marginal zone lymphoma (SMZL) with central recurrence,evaluation the safety and efficacy of rituximab intrathecal injection combined with intravenous chemotherapy.Methods Retrospectively analyze the case of SMZL with the central recurrence,and review the relevant literatures.Results According to the tests of MICM of bone marrow,spleen pathology,PET-CT and laboratory examination (LDH),patient was diagnosed as SMZL,IV group B,IPI and aaIPI was high risk group.After first-line therapy,the patient achieved complete remission.But then the central nervous system relapsed.The patients was treated with rituximab intrathecal injection combined with intravenous chemotherapy,the central focus disappeared.Conclusion SMZL belongs to low-grade lymphoma,which combined with central nervous system relapse is very rare.Rituximab intrathecal injection combined with intravenous chemotherapy in the treatment of the patients is safe to use,and have good clinical efficacy.

Objective To study the immunoreaction of the recombinant proteins encoded by the fragments of ORF2 ( second open reading frames) gene of hepatitis E virus ( HEV). Methods The aimed sequence from the full-length ORF2 in clone PEH2 , which was derived from a Chinese strain of HEV,was amplified and cloned it into vector pcDNAS. 1 which was then transfected to 293 cell. Results The ORF2 protein was present in the soluble fractions of the cell lysate. The expressed protein of HEV ORF2 in 293 cells by using a plasmid pcDNA3. 1-based system showed positive on immunoblots probed against antibodies raised in BALB/c mice. Conclusion The experimental results laid a foundation for developing diagnostic reagent to detect HEV by using the expressed products of ORF2 protein.

Objective To investigate the mosquito abundance and their relative species composition within and outside the Rare Birds National Nature Reserve of Yancheng,Jiangsu Province. Methods Sampling was carried out between May and Oct. 2004 at two weeks interval in two foci (the Reserve and nearby residential district) in Sheyang County. Mosquitoes were collected with the modified CDC light trap. Density was calculated,and species were identified. Environmental temperatures,rainfall and relative humidity were monitored during the study. Results A total of 40 912 mosquitoes were captured in the two foci. The sampled mosquitoes were identified as 4 species belonging to three genera (Anopheles sinensis,Culex pipiens pallens,Cx. tritaeniorhynchus,and Armigeres subalbatus). The most abundant mosquito species was An. sinensis and Cx pipiens pallens,which accounted for 97.7% of the whole number. 92% and 8% of the total amount of mosquitoes were collected from the nature reserve and residential district respectively. The most abundant species in the nature reserve and residential district was An. sinensis(60.6%) and Cx. pipiens pallens(76%),respectively. Within the nature reserve,there were two peaks occurred in adult abundance,in mid-and late July and mid-Sept. The abundance of mosquitoes in the area was positively correlated to the temperature (r=0.765,P=0.005). Conclusion The wetland is an ideal breeding place for An. sinensis and Cx pipiens pallens. The peaks of mosquito abundance are in mid-and late July and mid-Sept. It is of importance to carry out surveillance on mosquito vectors with pathogen-transmitting potential.

Objective To summarize the experiences in treatment of intertochanteric fractures with proximal femur nail antirotation (PFNA). Methods A retrospective study was done on 136 patients with intertrochanteric fractures treated with PFNA from March 2006 to September 2008. Postoperative reduction quality, long-term radiographic results and function of hip were evaluated separately. All the patients had closed fractures. The operation involved orthopedic traction bed, C-arm image intensifier,closed reduction or limited open reduction and locking technique. Results All patients were followed up for 10-18 months (average 14.5 months), which showed fracture healing in all patients. According to Harris criterion, the function of the hip joint obtained excellence in 129 patients ( 94.9% ). Conclusion PFNA has advantages of simple procedure, minimal invasion, firm fixation and early functional exercises and is an effective method for treatment of intertrochanteric fractures.

Objective:To investigate the effect and prognostic factors of rituximab-containing chemotherapy regimen in treatment of patients with mantle cell lymphoma (MCL).Methods:The clinical data of 56 patients aged ≤65 years in the First Affiliated Hospital of Soochow University from June 2007 to November 2018 were retrospectively analyzed. Rituximab-containing chemotherapy regimen was used, and the effects of clinical features, treatment regimen and biological indexes on overall survival (OS) and progression-free survival (PFS) were observed.Results:The median age of 56 patients was 57 years old, including 43 males and 13 females. Among these cases, 24 patients received R-CHOP chemotherapy regimen; 29 patients received cytarabine-containing chemotherapy regimen, including R-hyper CVAD/R-MA regimen used in 15 patients and R-CHOP alternating with R-DAHP regimen used in 14 patients; and 3 patients received other treatment regimens. Among 56 patients, 19 patients received autologous hematopoietic stem cell transplantation (ASCT) consolidation therapy. The median OS time was 74 months, 2-year OS rate was 83.8%, 3-year OS rate was 70.9%, 2-year PFS rate was 72.0% and 3-year PFS rate was 49.7%. International prognostic index (IPI) high-risk and receiving ASCT or not during the treatment were independent influencing factors of OS and PFS in MCL patients. The overall response rate (ORR) in cytarabine-containing regimen group was higher compared with that in R-CHOP regimen group (93.1% vs. 83.3%), and there was no statistically significant difference ( χ2=0.465, P=0.495). In addition, there were no significant differences between two groups in both OS ( χ2=0.291, P=0.590) and PFS ( χ2=0.912, P=0.339). ASCT consolidation prolonged the median OS time (72 months vs.124 months, χ2=3.973, P=0.040) and the median PFS time (34 months vs. 90 months, χ2=3.984, P=0.046) in MCL patients achieving remission after induction therapy. Among patients in simplified MCL IPI (sMIPI) score middle-high risk group, compared with those not receiving ASCT, patients receiving ASCT therapy could obtain better OS and PFS (OS: χ2=5.037, P=0.025; PFS: χ2=6.787, P=0.009); among patients of sMIPI score low risk, there were no statistically significant differences in OS and PFS between the group receiving ASCT and not (all P > 0.05). Conclusions:Cytarabine-containing chemotherapy regimen has no predicatively satisfactory value in improving the prognosis and survival for MCL patients. For MCL patients who have achieved remission after reduction therapy and those in sMIPI score middle-high risk group, ASCT consolidation therapy can improve the prognosis and can be taken as the first-line consolidation treatment in young patients.

Objective To investigate surgical exposure,reduction and fixation of the severe Pilon fractures. Methods A total of 11 patients with severe Pilon fractures (Rüedi-Allgwer type Ⅲ or AO/OT type C3 ) were managed by anteriormedial malleolar approach in combination with transfibular fracture or fibular osteotomy approach to reveal the tibiotalar joint.Reduction was performed under direct vision and then the tibia was fixed followed by fibula fixation. Results All patients obtained satisfactory bone reduction including nine patients with Ⅰ stage wound healing and two with Ⅱ stage wound healing.No sclerotin infection occurred.The fractures as well as the osteotomy sites were healed. Conclusions The double operative approaches can completely expose the tibiotalar joint,favor the reduction and fixation of the displaced bone fragments and attain satisfactory short-term reduction and fixation effects in the treatment of severe Pilon fractures.

Objective To obtain the basic growth parameters of a self-established F1 hybrid CB6F1 C57-ras transgenic mouse model, and to provide basic information for commercialization of this mouse model. Methods F1 hybrid mice (CB6F1) were produced by crossing C57-ras heterozygous transgenic (c-Ha-ras+/-) male mice and wild-type BALB/cJ female mice.The average litter size, weaning rate, sex ratio, growth performance and C57-ras transgenic positive rate were recorded and analyzed.Results The average litter size was eight, weaning rate was 90%, and sex ratio was approximately in accordance with prediction.The average body weight of newborn mice was 1.73 ±0.05 g.The average body weight of 10-week old c-Ha-ras transgenic female and male mice in CB6F1 background was 24.38 ±1.74 g and 29.42 ±1.72g, respectively, which had a significant difference (P<0.01).The c-Ha-ras transgenic positive rate was 46.9%. which was in accordance with genetic rules.Conclusions The F1 hybrid mice (CB6F1) produced by crossing C57-ras heterozygous transgenic ( c-Ha-ras +/-) male mice and wild-type BALB/cJ female mice show normal growth performance and development characteristics, and it can be used for large-scale commercial supply.

Objective To explore the efficacy of non-T cell depletion haploidentical hematopoietic stem-cell transplantation for T lymphoblastic lymphoma (T-LL). Methods 3 T-LL patients achieving complete remission received haploidentical bone marrow stem cell transplantation with granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow grafts from related donor without T-cell depletion. Two of them received a myeloablative conditioning regimen consisting of high-doses of cyclophosphamide and cytarabine with total body irradiation, whereas the other was preconditioned with busulfan, cyclophosphamide and cytarabine. All patients received strengthened phophylaxis regimen including rabbit anti-thymocyte globulin against acute graft-versus-host disease. Results All patients had rapid hematopoietic engraftment with the median time for neutrophil and platelet recovery being 12 days and 13 days, respectively. They are still alive without relapse at a median follow-up of 24 months (range: 9-75 months). Conclusion Treatment related toxicity can be acceptable in non-T cell depletion haploidenfical hematopoietic stem-cell transplantation for T-LL and the patients may achieve long term survival.